Chlorhexidine antisepsis may lead to higher endophthalmitis risk in intravitreal injections
A statistically significant difference in rates of endophthalmitis following intravitreal injections (IVIs) was found when comparing 2 different antiseptic agents in a retrospective cohort study conducted at a group retina practice in Canada.
The study compared the use of 10% povidone-iodine (PI) and 0.05% chlorhexidine (CH) in 4% alcohol antisepsis for IVIs.
The results revealed that the endophthalmitis rate was higher in the group that received CH antisepsis compared to the group that received PI antisepsis. Specifically, the odds of developing endophthalmitis were 3.1 times higher with CH antisepsis compared to PI antisepsis.
The study also noted an increased odds of developing endophthalmitis with aflibercept injection compared to bevacizumab injection.
The authors noted that alcohol-based CH is now considered a second-line antiseptic agent at the center, with PI remaining the primary choice for IVI antisepsis.
Reference
Mishra AV, Tong CM, Faes L, et al. Comparison of endophthalmitis rates following alcohol-based chlorhexidine and povidone-iodine antisepsis for intravitreal injections. Ophthalmol Retina. 2023;S2468-6530(23)00376-7. doi: 10.1016/j.oret.2023.08.007. Epub ahead of print. PMID: 37611695.
